Document Detail


Comparison between sevoflurane/remifentanil and propofol/remifentanil anaesthesia in providing conditions for somatosensory evoked potential monitoring during scoliosis corrective surgery.
MedLine Citation:
PMID:  19115644     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Somatosensory evoked potential (SSEP) monitoring is an important tool in spinal corrective surgery. Anaesthesia has a significant influence on SSEP monitoring and a technique which has the least and shortest suppressant effect on SSEP while facilitating a fast recovery from anaesthesia is ideal. We compared the effect of sevoflurane/ remifentanil and propofol/remifentanil anaesthesia on SSEPs during scoliosis corrective surgery and assessed patients' clinical recovery profiles. Twenty patients with idiopathic scoliosis receiving surgical correction with intraoperative SSEP monitoring were prospectively randomised to receive sevoflurane/remifentanil anaesthesia or propofol/remifentanil anaesthesia. During surgery, changes in anaesthesia dose and physiological variables were recorded, while SSEP was continuously monitored. A simulated 'wake-up' test was performed postoperatively to assess speed and quality of recovery from anaesthesia. The effects of propofol and sevoflurane resulted in SSEP amplitude variability between 18.0% +/- 3.5% to 28.7% +/- 5.9% and SSEP latency variability within 1.3% +/- 0.4% to 2.6% +/- 1.2%. Patients receiving sevoflurane had faster suppression and faster recovery of SSEP amplitude compared to propofol (P < 0.05), although propofol anaesthesia showed less within-patient variability in Cz amplitude and latency (P < 0.05). On cessation of anaesthesia, time to eye-opening (5.2 vs. 16.5 minutes) and toe movement (5.4 vs. 17.4 minutes) was shorter following sevoflurane (all P < 0.05). These findings indicate that propofol produces a better SSEP signal than sevoflurane. However adjustments in sevoflurane concentration result in faster changes in the SSEP signal than propofol. Assessment of neurological function was facilitated more rapidly after sevoflurane anaesthesia.
Authors:
N Y Fung; Y Hu; M G Irwin; B E M Chow; M Y Yuen
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anaesthesia and intensive care     Volume:  36     ISSN:  0310-057X     ISO Abbreviation:  Anaesth Intensive Care     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-12-31     Completed Date:  2009-02-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0342017     Medline TA:  Anaesth Intensive Care     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  779-85     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology, Duchess of Kent Children's Hospital, Hong Kong.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Anesthesia Recovery Period
Anesthetics, Combined / pharmacology
Anesthetics, Inhalation / pharmacology
Anesthetics, Intravenous / pharmacology
Evoked Potentials, Somatosensory / drug effects*
Humans
Methyl Ethers / pharmacology*
Monitoring, Intraoperative / methods*
Piperidines / pharmacology*
Propofol / pharmacology*
Prospective Studies
Reaction Time / drug effects
Scoliosis / surgery*
Time Factors
Chemical
Reg. No./Substance:
0/Anesthetics, Combined; 0/Anesthetics, Inhalation; 0/Anesthetics, Intravenous; 0/Methyl Ethers; 0/Piperidines; 132875-61-7/remifentanil; 2078-54-8/Propofol; 28523-86-6/sevoflurane

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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